Hemiballism-Hemichorea in presentation of cranial tuberculoma.
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Aged↗
Biomedical subjects
Feriha Ozer
Publications and source records attributed to Feriha Ozer.
Brainstem 1H-MR spectroscopy in patients with Parkinson's disease with REM sleep behavior disorder and IPD patients without dream enactment behavior.
OBJECTIVES: The objective of our study was to evaluate brainstem involvement by 1H-MR spectroscopy (1H-MRS) method in patients with idiopathic Parkinson's disease (IPD) with REM sleep behavior disorder (RBD) and IPD without dream enactment behavior. PATIENTS AND METHODS: We prospectively studied 12 IPD (3 females, 9 males) with a clinically and electrophysiologically confirmed RBD and 12 IPD (3 females, 9 males) patients without dream enactment behavior followed in Outpatient Clinics for Movement Disorders of Department of Neurology, Haseki Hospital. Using long and short TE single voxel 1H-MRS directed at ventral and dorsal pons, long TE NAA/Cr, Ch/Cr and short TE NAA/Cr, Ch/Cr, MI/Cr values of both groups were compared. RESULTS: Although no difference was found between groups with RBD and IPD without dream enactment behavior in demographic characteristics, duration of disease, mean levodopa dosage and duration of levodopa use, all UPDRS scores (total, motor and cognitive) were worse in RBD group (p<0.05). There was no statistically significant difference in long TE NAA/Cr, Ch/Cr and short TE NAA/Cr, Ch/Cr, MI/Cr values obtained in both groups (p>0.05). CONCLUSION: 1H-MRS does not detect marked metabolic differences in the pons in subjects with IPD with RBD and IPD without dream enactment behavior. This finding suggests either that present methodologies are not sensitive to detect subtle metabolic changes in the pons of subjects with RBD or that the primary lesion of RBD exists in other REM sleep-related brain regions beyond the pons such as the substantia nigra, the basal ganglia or the limbic system.
Aged↗
Multiple sclerosis and Hashimoto thyroiditis: two cases.
Multiple sclerosis (MS) occurs with immune-mediated mechanisms, but its pathogenesis is not accurately known. The coexistence of MS with other autoimmune diseases has been reported. The hypothesis that MS coexists with other autoimmune diseases has been supported by the reported association of MS with type I diabetes mellitus and inflammatory disorders. Even though there have been only rare reports of associations between Hashimoto thyroiditis and MS, this association is important for its clinical and therapeutic aspects. Proximal muscle weakness, myalgia, and fatigue are symptoms that are common in both MS and hypothyroidism. When MS patients demonstrate these symptoms, thyroid function tests should be performed. The thyroid hormone levels of MS patients being treated with interferon-beta and Campath-1H also should be monitored. The authors report the clinical data of 2 definite MS patients who also fulfilled criteria for Hashimoto thyroiditis.
Adult↗
Electroconvulsive therapy in drug-induced psychiatric states and neuroleptic malignant syndrome.
In the late-stage idiopathic Parkinson's disease (IDP), comorbid conditions such as depression and drug-induced psychosis may be observed. A patient with Parkinson disease, major depression, and paranoid psychosis who developed neuroleptic malignant syndrome (NMS) as the result of the sudden termination of high-dose (1200 mg/d) levodopa treatment is presented in this report. Because the patient did not respond to other treatment modalities, electroconvulsive therapy (ECT) was applied, and a rapid improvement was observed both in the patient's NMS and also in Parkinson's and psychiatric symptoms, with no additional side effects other than transient post-ictal confusions. The application of ECT allowed the patient to remain stable for a 5-year period with a quite low dose of levodopa (300 mg/d). Later, the patient had two episodes of depressive and psychotic symptoms, which were again successfully treated with the ECT. We suggest that ECT might be an effective and life-saving therapy in patients with severe, drug-resistant NMS.
Antiparkinson Agents↗
Wall-eyed bilateral internuclear ophtalmoplegia presenting as monocular alternating nystagmus: a non-epileptic phenomenon in a case of diffuse axonal injury.
A 15-year-old male in a persistent vegetative state due to diffuse axonal injury presented with seizures and spontaneous alternating monocular nystagmus. The cranial MRI revealed diffuse axonal injury involving supratentorial and infratentorial structures, and the splenium of the corpus callosum. The monocular alternating nystagmus was thought to be independent of seizures and occurred as a result of diffuse axonal injury affecting the medial longitudinal fasciculus bilaterally.
Accidents, Traffic↗
Non-ketotic hyperglycaemia presenting as epilepsia partialis continua.
Epilepsia partialis continua (EPC) is a rare epileptic syndrome, observed in various cortical lesions and also in metabolic disorders. We report the case of a 57-year-old patient with EPC as the first manifestation of hyperosmolar non-ketotic hyperglycaemia (NKH) of diabetes mellitus. Computed tomography (CT) and magnetic resonance imaging (MRI) were normal. Initial laboratory data revealing serum glucose 1540 mg/dl, and serum osmolality 391 mOsm/l confirmed the diagnosis. Electroencephalography (EEG) showed ictal discharges in the ipsilateral hemisphere during focal seizures. Seizures are resistant to anticonvulsant treatment and respond best to insulin and rehydration. Focal motor seizures or EPC are commonly a symptom of NKH in the elderly patients. We recommend that in such cases a metabolic disorder such as diabetes mellitus be ruled out.
Diagnosis, Differential↗
Reflex epilepsy and non-ketotic hyperglycemia.
Epileptic seizures are paroxysmal events, and it is likely that many, if not most, of them are precipitated by known or unknown factors acting on a central nervous system that is predisposed to the production of epileptic discharges by the presence of an organic lesion, a genetically determined neuronal hyperexcitability, or both. Known precipitating influences are quite varied. We report the case of a 58 years-old patient, followed for non-ketotic hyperglycemia, who presented with focal seizures exclusively induced by specific, active or passive, postures and movements of the right arm or hand. MRI was normal. Following regulation of glucose blood levels the position-induced seizures stopped and antiepileptics were not prescribed. The seizures are kept under control by regulating blood glucose.
Blood Glucose↗